Provider Demographics
NPI:1902577596
Name:MARQUEZ DIAZ, ANTONIETA CATALINA (SOCIAL WORKER)
Entity Type:Individual
Prefix:
First Name:ANTONIETA
Middle Name:CATALINA
Last Name:MARQUEZ DIAZ
Suffix:
Gender:F
Credentials:SOCIAL WORKER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1983 HUSTON CIR
Mailing Address - Street 2:
Mailing Address - City:WOODLAND
Mailing Address - State:CA
Mailing Address - Zip Code:95776-9325
Mailing Address - Country:US
Mailing Address - Phone:916-753-4357
Mailing Address - Fax:
Practice Address - Street 1:COLUSA COUNTY OFFICE OF EDUCATION
Practice Address - Street 2:499 MARGUERITE STREET, SUITE A
Practice Address - City:WILLIAMS
Practice Address - State:CA
Practice Address - Zip Code:95987
Practice Address - Country:US
Practice Address - Phone:530-473-1350
Practice Address - Fax:530-473-1342
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-23
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty